Provider Demographics
NPI:1003360306
Name:JABRI MEDICAL LTD.
Entity Type:Organization
Organization Name:JABRI MEDICAL LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:NAZHAT
Authorized Official - Last Name:JABRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-980-6227
Mailing Address - Street 1:303 E ARMY TRAIL RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2169
Mailing Address - Country:US
Mailing Address - Phone:630-980-6227
Mailing Address - Fax:630-980-2297
Practice Address - Street 1:303 E ARMY TRAIL RD
Practice Address - Street 2:SUITE 204
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2169
Practice Address - Country:US
Practice Address - Phone:630-980-6227
Practice Address - Fax:630-980-2297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036079512261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036079512Medicaid